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TKR RunningFree's Second TKR Recovery

Hi Layla, I’ve had a couple of difficult weeks since I stopped the codeine, I am managing on paracetamol mostly at night but they don’t seem to help much. I’m wondering if I should go back on the pain killers, I really don’t want to because they messed up my tummy to where I chose the knee pain over the tummy issues. I’ve only had one Physio sessions due to high demand on NHS and don’t have another appt till June.
I wish I could take anti inflammatory drugs but I’m on blood thinners and it’s not advised. I think I’m doing ok with my knee apart from pain. I can walk approximately 3/4 mile and I’m doing light housework etc., but I’m very tired and I’m conscious I don’t swing my foot through all the time when walking, I tend to leave it stiff because it’s painful to get started.

I’m 7 weeks 3 days so it’s still early I suppose.

This operation isn’t for Sissies and I have a high pain threshold, or so I always thought. If I could sleep it would help some.
 
I do still have a bottle of Morphine that I was told I could use if pain got too bad. I’ve wondered if that would put me back to sleep pain free if I used it for a couple of nights. Don’t think my dr would repeat the prescription, so it would be short term only. Any suggestions would be welcome.
 
It might be worth trying it to help you sleep. If you decide to use it, limit it to bedtime to help you sleep.
And make sure that you aren't driving the next day, since the after effects can linger.

Be sure you aren't overdoing the activity during the day. I found that doing too much often caused me increased pain at night. And keep icing and elevating. They are great for pain relief.
 
Hi Runningfree,
I am sorry you're having a rough time lately. I think the paracetamol may work better for you if you took it with some regularity, rather than just at night, or when you're really hurting. You need to make sure you are staying within the safe limits though of no more than 4000 mg in a twenty four hour period. You need to count all sources that contain paracetamol when calculating the 4000 mg.

Don't forget about ice and elevation also, if you've stopped. You may find it useful to do this right before bed also. It doesn't seem like you're engaged in too much activity, but you can always consider scaling back a little to see if you notice a difference. You mentioned swinging your foot through, definitely bring this up in physio so they can help you with your gait. Also, if it's not too difficult, try walking with a heel-toe gait. Hopefully a few small changes will help. Happy Sunday!

[Bonesmart.org] RunningFree's Second TKR Recovery
 
Thank you Layla I have stopped icing, I will start that again, it makes sense to take the paracetamol more regularly thank you for that advice. I am conscious of my walking and do try the heel through toe approach. I get relief from the stacked pillows to put my leg up. I have just browsed through the site and it’s so easy, sadly to find someone worse off than myself. It is a great site with so much help and kind words. Thank you for all you do.
 
I think you've been given very good advice - try the stronger stuff at night to see if you can get several uninterrupted hours of sleep. Then during the day, with regularity keep on paracetamol, within the limits. Ice and elevation were my best friends for several months into recovery.

During the day you might possibly be doing more than you think you are doing. That is still a baby brand new knee and needs to be treated as such. Rest when you can and try these adjustments and see if they don't help.
 
Thank you for your sweet sentiment in regard to BoneSmart, Runningfree, and for trusting our
suggestions / advice. It really means a lot that you chose to share your journey here.
I hope you have a nice week! :SUNsmile:
@Runningfree
 
Lots of good advice here @Runningfree re meds, please try to cut the walks down a little too. Shorter walks more often, I found this better than distance, concentrating on walking heel toe as Layla’s picture.
I iced for 4.5 months. It will get better, it’s early days.
 
Well thank you for the advice re meds Layla, it’s worked ! I take the codeine (at night only,) with two paracetamols, and stick to the paracetamols only during the day, I don’t exceed the limit. I have had 2 reasonable nights sleep, better sleep than any in the last 6 weeks and pain much more under control.

eaglemom said:
I think you've been given very good advice - try the stronger stuff at night to see if you can get several uninterrupted hours of sleep. Then during the day, with regularity keep on paracetamol, within the limits. Ice and elevation were my best friends for several months into recovery.

During the day you might possibly be doing more than you think you are doing. That is still a baby brand new knee and needs to be treated as such. Rest when you can and try these adjustments and see if they don't help.
Click to expand...
 
Legseleven said:
Lots of good advice here @Runningfree re meds, please try to cut the walks down a little too. Shorter walks more often, I found this better than distance, concentrating on walking heel toe as Layla’s picture.
I iced for 4.5 months. It will get better, it’s early days.
Click to expand...
 
Thanks Legseleven and Eaglemom, yes it’s all good advice, thank you for your words of help and reminders. I will shorten my daily walking distance too. However, I am on my feet longer than I should be. I am my husbands carer and even tho I have carers in to help him I still do more than I should. The last two days have been easier and less painful so hopefully I am getting over the worst of it at last.
 
Runningfree said:
I take the codeine (at night only,) with two paracetamols, and stick to the paracetamols only during the day, I don’t exceed the limit. I have had 2 reasonable nights sleep, better sleep than any in the last 6 weeks and pain much more under control.
Click to expand...
So happy this is working for you!

You're dealing with a lot on the daily, Runningfree, and a girl's gotta have her beauty sleep. :wink:
Healing while also being a loving caregiver to hubby has to be exhausting some days. Wishing you many more nights of peaceful sleep.
 
I found standing much harder than walking early on. If you are having to do a fair bit of standing as a carer, then I am not surprised you are finding things hard. Just go easy on yourself and adjust your activity to allow for your caring work.
I carried on icing for months as I found it comforting after exercise or before sleep.
 
Yes I agree standing is worse than walking, EalingGran. I am in less pain this week (8th), but my energy levels are really quite low. I am taking more rest and earlier nights in a hope to combat the fatigue. I basically do too much and a lot of it is my fault. I’m too independent.
 
Fatigue and low energy are absolutely normal at your stage. Just rest as much as you can between what you have to do. I was very lucky not to have to do anything apart from concentrate on my recovery and I still found it tiring. You are doing really well
Don't be more independent than you have to be though. Ask for help where you can and cut corners on housekeeping. Dust really doesn't matter and we lived on ready meals for months. It's more important to concentrate on your recovery.
 
I bought a Roomba to help with my vacuuming. It's not great, but is definitely better than pushing a vacuum at your stage of healing. Your #1 job right right now is still to heal. That means rest is needed to aid that healing.

Low energy is quite normal at your recovery stage. Take time to replenish your energy and you'll find you will slowly be able to do more.
 
Hi I’m at 10 weeks and one day post RTKR and there is a noticeable shift in pain relief thank goodness. I have been off medication for 3 days, my mood has lifted and I think I have a bit more energy, certainly my brain wants me to do more. I’m still using two crutches for dog walks as it’s uneven ground and sticking out tree roots. But I don’t use them in the house/garden. I have balance issues from a previous brain tumour so I err on the cautious side.
My problem is sleep. I only get 2 or maybe 3 hours then wake up, I drift in and out of sleep the rest of the night. Im a girl that used to sleep 7 hours every night, I would give anything to sleep longer and deeper. Maybe it’s a matter of time who knows. Any tips would be welcome. I feel so grateful I have very manageable discomfort now.
 
I have been a poor sleeper for years and it was definitely worse after my PKR.
Even small amounts of discomfort, which don't bother you during the day will keep you awake.
Here are the following tips that I found useful.
I iced before bed and then slept with my knee resting on the open iced water jacket of my Aircast Cryocuff ( refilling with cold water when I woke to go to the toilet).
I got a short prescription of zopiclone from my GP, which I interspersed with diphenhydramine ( Nytol in UK) from the chemist, to avoid any tolerance. Later I gradually switched to herbal valerian and melatonin.
Some people find magnesium helpful, but it didn't do much for me.
Limit any caffeinated drinks after about lunchtime.
In the early stages after surgery, just rest and sleep when you can. But later, try to avoid daytime naps and get back to a regular bedtime, avoiding any blue light/ screens before bed.
Lack of sleep is miserable. Good luck.
 
Hi Runningfree,
Bravo for getting off meds, improved mood and more energy...all nice progress! I'm sorry for the health challenge you faced and understand wanting the stability of an assistive device while outdoors on uneven terrain. Better safe than sorry! I do believe your sleep will regulate given more time and, EalingGran, has shared some useful tips above.

Pillows help me get comfortable in bed, making it easier to fall asleep. You can experiment with different arrangements to find what works for you. I surrounded myself with them so I could rest a leg, or arm easily enough, whatever felt comfortable. Doing whatever you can to basically "set the scene" for sleep may be worthwhile. I suggest making up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down. Limit caffeine throughout the day and consider natural sleep aids such as Valerian, Chamomile or, Magnesium, my personal favorite, which can assist in muscle relaxation and nerves and promote healthy sleep (falling asleep and staying asleep)

I agree with EalingGran's suggestion of icing before bed to reduce swelling and numb the discomfort. Try some relaxation techniques if you feel they may work for you such as deep breathing, prayer or meditation or even some gentle stretching may help relax your body and mind.

An article on Magnesium from our Library -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/

Most large grocers carry a variety of teas such as Celestial Seasonings - Sleepytime Herb Tea,
Yogi Teas, Bedtime, Bigelow Cozy Chamomile, all of which may help you relax...at least worth a try.

Wishing you many nights of peaceful sleep soon!
@Runningfree
 
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